Women urged to seek STD testing within 12 months of first intercourse.

Source: AMA Morning Rounds 12/8/09

Women urged to seek STD testing within 12 months of first intercourse.

The Los Angeles Times (12/7, Roan) "Booster Shots" blog reported, "Young women should be screened for sexually transmitted diseases within a year of first intercourse and should be retested every three to four months if an infection is found, according to a study published...in the Archives of Pediatrics and Adolescent Medicine." Indeed, the "US Preventive Services Task Force and Centers for Disease Control and Prevention have recommendations for STD screening, but those documents are somewhat vaguely worded." The work conducted by researchers at Indiana University, however, "suggests that starting at a young age and conducting regular screening may prevent many health problems," such as pelvic inflammatory disease and ectopic pregnancy, in the years to come.

Diabetes cases projected to nearly double in next 25 years.

Source: AMA Morning Rounds 11/30/09

Diabetes cases projected to nearly double in next 25 years.

The Chicago Tribune (11/27, Shelton) reported that, according to a study published Nov. 27 in the journal Diabetes Care, "diabetes cases will nearly double in the US in the next 25 years and the cost of treating the disease will almost triple." University of Chicago researchers "found the number of people with diagnosed and undiagnosed diabetes will climb from almost 24 million this year to about 44 million in 2034. Over the same period, annual diabetes-related treatment costs are expected to increase from $113 billion to $336 billion in 2007 dollars."

        Bloomberg News (11/27, Waters) reported, "Diabetes prevents people from breaking down sugar in their blood and can lead to complications, including heart disease, kidney disease, vision loss, and amputation of limbs. While some people have an inherited form of the condition, the majority of cases are linked to obesity."

        HealthDay (11/27, Thomas) reported that, besides obesity, another "factor driving the soaring costs" is "the number of people living with diabetes for lengthy periods, the researchers said. Over time, the cost of caring for someone with diabetes tends to rise along with their risk for developing complications, such as end-stage renal disease, which requires dialysis." Notably, "among Medicare beneficiaries, the number with diabetes is expected to rise from 8.2 million to 14.6 million in 2034, with an accompanying rise in spending from $45 billion to $171 billion."

        "As a result, by 2034, half of all direct spending in diabetes care is projected to occur in the Medicare population," WebMD (11/27, Boyles) reported. Still, "although little can be done about the aging of the population, much can be done about the other major risk factor for type 2 diabetes -- obesity." MedPage Today (11/27, Gever) and CNN (11/27, Hellerman) also covered the study.

        Rituximab seen as promising for type 1 diabetes. Bloomberg News (11/26, Doherty) reported that, according to a study in the Nov. 26 issue of the New England Journal of Medicine, the "arthritis and lymphoma medicine Rituxan [rituximab] cut the need for insulin treatment among patients with type 1 diabetes after a year."

        In a phase 2 trial, researchers from Indiana University randomly assigned "87 patients with newly diagnosed type 1 diabetes...to receive rituximab infusions or a placebo at one-week intervals for four weeks," HealthDay (11/25, Gardner) reported. The investigators discovered that "after one year, C-peptide levels -- an indicator of how much insulin is being produced by the body -- were higher in people taking rituximab versus those in the placebo group," with "those in the rituximab group also" needing "less external insulin." In other words, rituximab "helped patients keep producing some of their own insulin."

        WebMD (11/25, DeNoon) noted, however, that "a single course of Rituxan wasn't enough to stop diabetes. After a year, B cells in treated patients increased to 69% of their original values." Nevertheless, "the study does show that a treatment targeting B cells can preserve beta-cell function in early type 1 diabetes."

        MedPage Today (11/25, Gever) reported that Joel Zonszein, MD, of the Albert Einstein College of Medicine, cautioned, "The molecule [rituximab] is not free of side effects, and" that "important long-term side effects are unknown." Dr. Zonszein, who was not involved in the study, agreed, however, that the "study opens a new pathway of exploration."

Pharmacists seen as integral to helping patients manage healthcare.

Moral of the story: Physicians need help from pharmacists, especially considering the high number of drugs people take these days and all the potential interactions that can occur.

Source: AMA Morning News 11/20/09

Pharmacists seen as integral to helping patients manage healthcare.

In a series of articles on pharmacists and their role in managing patients' healthcare, the Los Angeles Times (11/30, Ravn) reports, "Pharmacists now can help patients get the most good from their medications, manage side effects, avoid interactions, even save money." Most states also "have laws requiring pharmacists to give patients specific information," and in California, the law specifies that pharmacists "should give patients directions for how to use and store their medications, making clear that it's important to follow those directions." In addition, "they should warn patients about possible side effects or interactions that occur frequently and may be severe."

        In a separate article, the Los Angeles Times (11/30, Ravn) reports on "a growing subset" of pharmacists called "clinical pharmacists," who "provide direct care, using their expertise to ensure that patients receive the most appropriate medications and that they take them properly. These professionals often spend time with patients that physicians can't." Evidence also "shows that when clinical pharmacists collaborate with physicians, they improve health outcomes. And with their extensive knowledge of available drugs, pharmacists can help to save money by using the most cost-effective ones."

        The Los Angeles Times (11/30, Ravn) also reports on "medication therapy management" and how "it's crucial to ensure that none of the patient's medications are duplicating each other, or canceling each other out, or interacting in a problematic, even dangerous way." In medication therapy management, "the pharmacist can work with a patient's physician (or physicians) to develop a comprehensive program of drug therapy -- perhaps eliminating or adding or switching medications," which can help save "the patient money and, more important," improve "the patient's health."

        The Los Angeles Times (11/30, Ravn) also includes an article detailing "a list of questions" patients "should pose before taking your medications home." The Los Angeles Times (11/30, Ravn) also runs a story on "five of the most-prescribed drugs and their possible risks, side effects, and possible interactions."

Many medical students sustain needle-stick injuries, data indicate.

Moral of the story: Reporting needs to be made simpler, faster.

Source: AMA Morning Rounds 11/30/09

Many medical students sustain needle-stick injuries, data indicate.

The Los Angeles Times (11/25) "Booster Shots" blog reported that, according to research appearing in the Dec. issue of the journal Academic Medicine, "medical students often come in too-close contact with needles, possibly putting them at risk for contracting HIV or hepatitis C." The survey of "699 surgeons-in-training at 17 general surgery residency programs," showed that "almost 60 percent said they sustained a needle-stick injury as a medical student, with many suffering two injuries."

        Those "who had been stuck in medical school" also "had a 2.51-fold increased risk of needle-stick injury involving a high-risk patient -- one with a history of intravenous drug use or infection with HIV, HBV, or HCV," MedPage Today (11/27, Fiore) reported. But, data indicated that 47 percent of respondents who "sustained their most recent needle-stick injury during medical school" failed to "report their injury to an employee health office." Researchers found that "the most common reason for not doing so was the amount of time involved in making a report."

Study shows no link between increased cell phone use, brain cancer incidence.

Moral of the story: No proven connection between cell phone use and brain cancer, although it wouldn't hurt to be careful.

Source: AMA Morning Rounds 12/4/09

Study shows no link between increased cell phone use, brain cancer incidence.

NBC Nightly News (12/3, story 9, 0:20, Williams) reported, "There's been speculation for years that there's been a link between" cell phones and brain cancer, but "the results of a very large, very long study of just about everybody in Scandinavia found no link."

        USA Today (12/4, Szabo) reports that, according to the study, published in the Journal of the National Cancer Institute, researchers found "no link between rising cell phone use and rates of brain cancer." The finding is "consistent with most other studies," but Melissa Bondy, of MD Anderson Cancer Center, noted that "even if the study had found an increase in brain tumor rates," cell phones may not be "to blame," because "lots of other trends" can "help explain changes in disease rates."

        The Los Angeles Times (12/3, Roan) "Booster Shots" blog reported that "the study is important, because it mirrors the international Interphone case-control studies which have shown no overall increase in glioma or meningioma rates." The authors of the current study pointed out, however, that "the Interphone studies...'leave open the possibility of a small to moderate increased risk for glioma among the heaviest users of mobile phones.'"

        Their own analysis of "data on 60,000 people diagnosed with glioma and meningioma in Denmark, Finland, Norway, and Sweden" revealed that "the incidence of brain tumors...were stable, decreased, or gradually increased, starting before cell phones became popular," HealthDay (12/3, Reinberg) reported. They also found "no change in incidence of brain tumors...during a period of rapid increase in cell phone usage."

        The researchers argued that "if cell phones were a significant cause of brain tumors after five to 10 years of usage," the "incidence rates should show an acceleration in brain tumors relative to earlier trends," MedPage Today (12/3, Gever) reported. They speculated that "increased brain cancer rates may simply reflect an increase in diagnoses from new imaging technologies."

        WebMD (12/3, Hendrick) reported that the authors mentioned other "reasons for their finding," including that "the induction period relating cell phone use to brain tumors exceeds five to 10 years," or that "the increased risk is restricted to subgroups of brain tumors or cell phone users." Reuters (12/3, Fox) also covered the story.